Monitoring Quality in a Federal State with Shared Powers in Healthcare: The Case of Belgium

2011 ◽  
Vol 18 (4) ◽  
pp. 413-422 ◽  
Author(s):  
Diego Fornaciari ◽  
Arthur Vleugels ◽  
Stefaan Callens ◽  
Kristof Eeckloo
Keyword(s):  
Healthcare System ◽  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Federal State ◽  
Flemish Community ◽  
The Government ◽  
Regulatory Powers ◽  
Monitoring Quality

AbstractThe Belgian healthcare system consists of a complex of more or less autonomous groups of healthcare providers. It is the responsibility of the government to ensure that the fundamental right to qualitative healthcare is secured through the services they provide. In Belgium, the regulatory powers in healthcare are divided between the federal state and the three communities. Both levels, within their area of competence, monitor the quality of healthcare services. Unique to the Belgian healthcare system is that the government that providers are accountable to is not always the same as the government that is competent to set the criteria. The goal of this article is to provide an overview of the main mechanisms that are used by the federal government and the government of the Flemish community to monitor healthcare quality in hospitals. The Flemish community is Belgian’s largest community (6.2 million inhabitants). The overview is followed by a critical analysis of the dual system of quality monitoring.

scholarly journals 生命倫理基礎的形成——從中國醫療衛生體制改革的歷史進程看

2012 ◽  
Vol 10 (2) ◽  
pp. 93-114
Author(s):  
Lin BIAN
Keyword(s):  
Healthcare System ◽  
Healthcare Reform ◽  
Public Policies ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Economic Transformation ◽  
Moral Foundation ◽  
Digital Commons ◽  
The Government

LANGUAGE NOTE | Document text in Chinese; abstract also in English.在中國醫療衛生體制改革近30 年的風雨歷程中，由於前改革時期沒有條件形成公共生活的倫理精神，在醫療衛生體制改革的第一階段，即過渡期的10幾年中，同樣沒有能夠為改革確立合理的價值目標和形成強有力的道德基礎。在此後改革的推進期，政策制定和制度安排過程倫理基礎的缺失，是改革不成功的重要原因之一。中國社會在對改革的質疑和經驗教訓的反思中啟動的新一輪醫改，無論是政策制定還是框架設計，以及幾年來所取得的成就，都表明此一輪改革具備了較為自覺的生命倫理意識和公共生活倫理精神。中國醫療衛生體制改革的生命倫理基礎生成過程表明，生命倫理學研究在方法上應該堅持中國化的立場。Medical and healthcare reform in China over the past three decades has faced various challenges, one of which has been the lack of an ethical spirit in public life. The old moral foundation has collapsed and a new ethical system has not been established. It follows that neither the validity of reform nor public policies derived from that reform have a solid moral and ethical foundation. As the government seeks an effective way of reshaping the national healthcare system in terms of quality and accessibility to keep pace with rapid socio-political and economic transformation, it has to deal with various moral challenges. This essay provides a critical review of healthcare reform in past 30 years, with the shift away from a state-controlled, comprehensive healthcare system. While “fairness” is considered an ethical principle in a socialist systemlike China, it has always been a problem in reality given the huge disparity between wealthy cities and poverty-stricken countryside brought about by differences in economic situations and medical human resources. The reform has been welcomed by many, but it has also led to a decline in the scope and quality of healthcare services in certain regions. Hence, recent healthcare changes have focused primarily on grassroots medical networks, which aim to penetrate lower-tier and remote regions. However, the moral basis for these changes is ambiguous. The essay argues that it is crucial for Chinese scholars, healthcare professionals, and government administrators to think about the moral foundation upon which legal regulations and public policies can be implemented to meet specific needs in China.DOWNLOAD HISTORY | This article has been downloaded 34 times in Digital Commons before migrating into this platform.

scholarly journals Perceived Consequences of Healthcare Service Decentralization on Access, Affordability and Quality of Care in Khartoum Locality, Sudan

2020 ◽  
Author(s):  
Bandar Noory ◽  
Sara Hassanein ◽  
Jeffrey Edwards ◽  
Benedikte Victoria Lindskog
Keyword(s):  
Quality Of Care ◽  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
System Capacity ◽  
Cross Sectional ◽  
Study Results ◽  
Catchment Areas ◽  
The Impact

Abstract Background: Decentralization of healthcare services have been widely utilized, especially in developing countries, to improve the performance of healthcare systems by increasing the access and efficiency of service delivery. Experiences have been variable secondary to disparities in financial and human resources, system capacity and community engagement. Sudan is no exception and understanding the perceived effect of decentralization on access, affordability, and quality of care among stakeholders is crucial.Methods: This was a mixed method, cross-sectional, explorative study that involved 418 household members among catchment areas and 40 healthcare providers of Ibrahim Malik Hospital (IBMH) and Khartoum Teaching Hospital (KTH). Data were collected through a structured survey and in-depth interviews from July-December 2015.Results: Access, affordability and quality of healthcare services were all perceived as worse, compared to before decentralization was implemented. Reported affordability was found to be 53% and 55% before decentralization compared to 24% to 16% after decentralization, within KTH and IBMH catchment areas respectively, (p= 0.01). The quality of healthcare services were reported to have declined from 47% and 38% before decentralization to 38% and 28% after, in KTH and IBMH respectively (p=0.02). Accessibility was found to be more limited, with services being accessible before decentralization approximately 59% and 52% of the time, compared to 41% and 30% after, in KTH and IBMH catchment areas respectively, (p=0.01).Accessibility to healthcare was reported to have decreased secondary to facility closures, reverse transference of services, and low capacity of devolved facilities. Lastly, privatized services were reported as strengthened in response to this decentralization of healthcare. Conclusions: The deterioration of access, affordability and quality of health services was experienced as the predominant perception among stakeholders after decentralization implementation. Our study results suggest there is an urgent need for a review of the current healthcare policies, structure and management within Sudan in order to provide evidence and insights regarding the impact of decentralization.

e-Healthcare service quality: consumer satisfaction and its association with demographic characteristics

2020 ◽  
Vol 33 (6) ◽  
pp. 413-428 ◽  
Author(s):  
Prachi Verma ◽  
Satinder Kumar ◽  
Sanjeev K. Sharma
Keyword(s):  
Consumer Satisfaction ◽  
Strong Association ◽  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Demographic Characteristics ◽  
Content Type ◽  
Interaction Quality ◽  
Quality Dimensions

PurposeUse of technology for quality healthcare services has developed into a new field known as “e-Healthcare services.” Healthcare providers often judge their quality of services with consumer satisfaction. With e-Healthcare services, consumer satisfaction is influenced by the quality of healthcare services provided and the demographic characteristics. The purpose of the present case study is to recognize the important predictors of quality, which are significant for consumer satisfaction with e-Healthcare services by using Zineldin's 5Qs model. It also aims to find the strength of association among the predictors of consumer satisfaction and the demographic characteristics of the respondents.Design/methodology/approachA questionnaire-based study was conducted at a public (PGIMER, Chandigarh) and a private hospital (Fortis Hospital, Mohali) of Punjab, India, from February 2018 to March 2019. The structured, closed-ended questionnaire, to be marked on a 1–5 point Likert scale, was adapted from Zineldin's 5Qs model and was distributed to the respondents sitting in the waiting halls of the selected hospitals. The respondents comprised of both the patients and their attendants who were aware of e-Healthcare services and were using them.FindingsThe analysis identified quality of interaction, quality of hospital atmosphere and quality of object to be the key predictors of consumer satisfaction with e-Healthcare services. The results reveal a strong association between different demographic characteristics and overall consumer satisfaction with e-Healthcare services.Practical implicationsThe results suggest that improvements in the quality of interaction, quality of hospital atmosphere and quality of object may result in higher consumer satisfaction with e-Healthcare services. Working on the identified dimensions of quality will help the e-Healthcare providers in identifying functional problems of e-Healthcare services and developing improvement strategies, which will also result in better health and quality outcomes. The results of this study will help the e-Healthcare providers in better segmentation of e-Healthcare consumers based on their demographic characteristics and in developing better marketing strategies.Originality/valueThis paper focuses on the quality of e-Healthcare services only and attempts to identify the quality dimensions, which leads to the satisfaction of e-Healthcare consumers. The identified quality dimensions will help in designing better e-Healthcare services and framing policies. It also highlights the association of demographic characteristics with important quality dimensions.

Demystifying Quality of Healthcare in the Cloud

2014 ◽  
pp. 284-301 ◽  
Author(s):  
Anastasius Moumtzoglou
Keyword(s):  
Cloud Computing ◽  
Sharp Increase ◽  
Healthcare Professionals ◽  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Treatment Techniques ◽  
New Applications ◽  
Elusive Concept

Healthcare services have experienced a sharp increase in demand while the shortages in licensed healthcare professionals have formed one of the toughest challenges that healthcare providers face. In addition, illness has become more complex while advancement in technology and research have expedited the rise of modern and more effective diagnoses and treatment techniques. Cloud computing allows healthcare professionals to share medical records, including all sorts of image and accuracy while new applications or workloads can be started much faster, without going through the entire procurement process or testing the interoperability of the entire infrastructure. Moreover, although the notion of organizational culture is now routinely invoked in organizations and management literature, it remains an elusive concept. However, it is clear that managing the culture is one path towards improving healthcare, and cloud computing introduces a dynamic system adaptation, affecting the quality of care. This is explored in this chapter.

scholarly journals Patient satisfaction with healthcare services: Bangladesh perspective

2020 ◽  
Vol 9 (1) ◽  
pp. 34
Author(s):  
Absul Kader Mohiuddin
Keyword(s):  
Patient Satisfaction ◽  
Service Providers ◽  
Waiting Times ◽  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Poor Quality ◽  
Access To Health Services ◽  
Long Distance

<p>Patient satisfaction is a useful measure for providing a quality benchmark for healthcare services. Concern about the quality of healthcare services in Bangladesh has led to a loss of confidence in healthcare providers, low use of public health facilities and increased outflows of patients from Bangladesh to hospitals abroad. The key obstacles to access to health services are insufficient infrastructure and poor quality of existing facilities, lack of medical equipment, scarcity of doctors due to high patient load, long distance to the facilities and long waiting times until facilities have been reached, very short appointment hours, lack of empathy of health professionals, their generally callous and casual attitude, aggressive pursuit of monetary gains, poor levels of competence and, occasionally, disregard for the suffering that patients endure without being able to voice their concerns-all of these service failures are reported frequently in the print media. Such failures can play a powerful role in shaping patients’ negative attitudes and dissatisfaction with healthcare service providers and healthcare itself.</p>

scholarly journals Observance of patients’ rights by physicians and nurses from the COVID-19 patients’ perspective

2021 ◽  
Author(s):  
Mohsen Kamali ◽  
Seyed Kazem Mousavi
Keyword(s):  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Patients Rights ◽  
The Social ◽  
The Mean ◽  
Patients Perspective

Observance of patients' rights is a significant indicator in evaluating the quality of healthcare services. The COVID-19 pandemic has become a global crisis and affected the interactions between healthcare providers and patients. This study examined the COVID-19 patients’ viewpoint about the observance of their rights by physicians and nurses. This study is a descriptive cross-sectional work of research conducted on the COVID-19 patients in Zanjan Province, Iran, in September 2020. The subjects were selected through convenience sampling, and data was collected using a two-section questionnaire consisting of a demographic characteristics survey and a Likert-type scale for evaluating patients' rights observance. The validity and reliability of the questionnaire were found to be acceptable, and the collected data was analyzed in SPSS v.26 using descriptive statistics, independent t-test, and ANOVA test. The mean score of observance of patients' rights was 69.60±7.36, representing a moderate level. The highest and lowest scores for the observance of patients' rights were related to the dimensions of courteous communication and responsibility, respectively. A significant relationship was found between the observance of patients’ rights and their marital status, health insurance, and education level (P<0.05). This study showed that the observance of the COVID-19 patients' rights has not been affected by the social agitation caused by this disease.

scholarly journals Perceptions of Good-Quality Antenatal Care and Birthing Services among Postpartum Women in Nepal

2021 ◽  
Vol 18 (13) ◽  
pp. 6876
Author(s):  
Sushma Rajbanshi ◽  
Mohd Noor Norhayati ◽  
Nik Hussain Nik Hazlina
Keyword(s):  
Quality Of Care ◽  
Low Socioeconomic Status ◽  
Healthcare Providers ◽  
Healthcare Facility ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Interpersonal Behavior ◽  
Postpartum Women ◽  
Health Seeking

Patient complaints and dissatisfaction should be taken seriously and used as an opportunity to provide acceptable services. Mounting evidence shows that the perception of the quality of healthcare services impacts health-seeking behaviors. This study explores the perceptions of good-quality antenatal and birthing services among postpartum women. A qualitative study using phenomenological inquiry was conducted in the Morang district, Nepal. The study participants were postpartum women with at least one high-risk factor who refused the referral hospital’s birth advice. A total of 14 women were purposively selected and interviewed in-depth. NVivo 12 Plus software was used for systematic coding, and thematic analysis was performed manually. Three themes emerged: (i) women’s opinions and satisfactory factors of health services, (ii) expectations of the health facility and staff, and (iii) a lack of suggestions to improve the quality of care. Women did not have many expectations from the healthcare facility or the healthcare providers and could not express what good quality of care meant for them. Women from low socioeconomic status and marginalized ethnicities lack knowledge of their basic reproductive rights. These women judge the quality of care in terms of staff interpersonal behavior and personal experiences. Women will not demand quality services if they lack an understanding of their basic health rights.

scholarly journals Assessing Quality of Healthcare Delivery When Making Choices: National Survey on Health Consumers’ Decision Making Practices

2021 ◽  
Vol 16 (1) ◽  
pp. 11-20
Author(s):  
Mark Avery ◽  
Allan Cripps ◽  
Gary D Rogers
Keyword(s):  
Decision Making ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Third Party ◽  
Healthcare Needs ◽  
Interpersonal Engagement ◽  
And Performance

Objective: Choices and quality decisions made by consumers in relation to their healthcare have been associated with personal experience of those services, interpersonal engagement and reliance on third-party information, as well as the subsequent satisfaction with the service. The purpose of this research was to understand current information sources, determinants of quality discernment and decision-making factors by consumers in the Australian community in relation to healthcare. Method:  Conventional content analysis research was undertaken in the form of a national telephone survey of 200 consumers. Open-ended questions were used to elicit information from the general community. Results: Reputation and other key interpersonal and structural elements are utilised in determining quality of healthcare services as well as in deployment as key factors in decision-making regarding use of healthcare services. While most respondents valued and used key information about provider relationships, outcomes performance and performance rankings, up to 20% of respondents did not know or could not identify ways in which they would assess and evaluate the quality of healthcare services. Conclusion: This research identifies that consumers use a range of information and advice relating to experience, interpersonal engagement and information from third-party sources. If healthcare providers develop clearer communications around their technical, procedural and conduct principles, consumers will be in a better position to evaluate reputation and make decisions about their healthcare needs and the health system.

Demystifying Quality of Healthcare in the Cloud

2015 ◽  
pp. 1334-1350
Author(s):  
Anastasius Moumtzoglou
Keyword(s):  
Cloud Computing ◽  
Sharp Increase ◽  
Healthcare Professionals ◽  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Treatment Techniques ◽  
New Applications ◽  
Elusive Concept

Healthcare services have experienced a sharp increase in demand while the shortages in licensed healthcare professionals have formed one of the toughest challenges that healthcare providers face. In addition, illness has become more complex while advancement in technology and research have expedited the rise of modern and more effective diagnoses and treatment techniques. Cloud computing allows healthcare professionals to share medical records, including all sorts of image and accuracy while new applications or workloads can be started much faster, without going through the entire procurement process or testing the interoperability of the entire infrastructure. Moreover, although the notion of organizational culture is now routinely invoked in organizations and management literature, it remains an elusive concept. However, it is clear that managing the culture is one path towards improving healthcare, and cloud computing introduces a dynamic system adaptation, affecting the quality of care. This is explored in this chapter.

scholarly journals The Personal Electronic Health Folder and the usefulness of electronic systems to improve health services

2020 ◽  
Vol 13 (4) ◽  
pp. 19-25
Author(s):  
Christina Girtsou ◽  
Pantelis Stergiannis ◽  
Theoharis Konstantinidis ◽  
Georgios Martinis
Keyword(s):  
Information Transfer ◽  
Clinical Status ◽  
Healthcare Providers ◽  
Control Process ◽  
Chronically Ill ◽  
The Elderly ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Electronic Health

Continuity in patient healthcare shows significant gaps and variations, due to reduced communication between healthcare services. The information transfer to all stages of health structures is often inadequate with many variations, especially at the critical stage after discharge from the hospital, in which patients are usually more vulnerable. The major problem of the lack of interconnection between healthcare services occurs mainly among the elderly, the chronically ill and those who take a lot medication. The main effects of this problem are medication side effects, treatment overlap, poor quality of healthcare and financial costs. Enhancing communication, through the electronic interface and the use of the Personal Electronic Health Folder (P.E.H.F.), which will include the individual details of each patient and information about his clinical status, is aiming at the use of best practices for patient recovery by healthcare providers. The thorough literature review, the strategic analysis PESTEL and the control process, pointed out the need to use the P.E.H.F., to achieve substantial improvements in the quality of patient healthcare. With the practical use of P.E.H.F., the healthcare of all patients will be unquestionably, safe, effective, patient-centered, immediate and fair.

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